Sticky fix: Surgeons using 'super glue' to mend baby's brain

Doctors at the University of Kansas Hospital used surgical 'super glue' to treat an infant suffering from a hemorrhaging brain aneurysm. KSHB's Jadiann Thompson reports.

A 3-week-old girl was recovering Tuesday from life-saving brain surgery after Kansas surgeons used a sterile surgical glue to seal the infant's bleeding aneurysm.

Ashlyn Julian has shown no complications from the June 5 procedure at The University of Kansas Hospital in Kansas City, Kan., and may go home as soon as next week, doctors say. Her surgeons described the baby as looking “pink” and “healthy” and bundled “like a small burrito.”

The surgery — a delicate dance of hand movements inside the tiniest of brains — is believed to mark the first time glue has been used to repair an aneurysm in an infant less than a month old, the hospital said.

“I didn’t know for sure if we could get to the aneurysm, to be honest,” said Dr. Koji Ebersole, an endovascular neurosurgeon who painstakingly delivered the dollop of glue to the precise spot of the leak using a micro-catheter the size of lead inside a mechanical pencil.

Surgical adhesive — a compound similar to store brand Super Glue — is commonly used in brain procedures, mainly in adults. But the Kansas doctors called the precise fusing of Ashlyn’s brain bleeds a “once-in-a-career case.” The cause of her aneurysm remains unknown.

Ebersole and his colleague, Dr. Alan Reeves, an interventional neuroradiologist, inserted the micro-catheter into one of the baby’s leg arteries then wormed it up and through her body and, eventually, into her brain, watching it constantly through an X-ray monitor.

The catheter carried a micro-wire, slightly larger than a human hair, which Ebersole ultimately used to dab the glue onto the aneurysm.

He had less than 10 seconds to apply the adhesive then retrieve the micro-wire back into the catheter. After all, the stuff is just like Super Glue, the doctors said.

“That’s a tricky part,” Reeves said “You only are allowing yourself literally a few seconds. The people who don’t allow themselves that (time) glue the catheter to the brain. And that’s not something anybody is proud of.

“That’s something Dr. Ebersole was hyper-aware of as the glue was being pushed through the catheter: the exact amount of working time that’s afforded with glue. You have a very short window,” Reeves added.

What happens if a catheter ever becomes super-glued to a patient's brain?

“At that point, the only recourse is just to cut the catheter off at the leg,” Reeves said.

The glue will turn into a scar and eventually dissolve, leaving the aneurysm sealed, said Ebersole, who added: “It's too soon to say for sure, but I feel strongly that she can proceed to have a normal life.”

One of the pioneers of using glue to repair brains was New York City neurology professor Dr. Alejandro Berenstein, who says he has healed the brains of hundreds of children with tiny dots of glue. (None of them were babies less than one-month-old who had been diagnosed with aneurysms — a condition marked only 17 times in medical literature).

“Probably, if I’ve done anything good in my life is treat these babies with the vein of Galen (malformation), practically a lethal disease,” Berenstein, a professor of radiology, neurology, and neurosurgery at the Albert Einstein College of Medicine the Bronx, N.Y., said in a 2011 TEDMED talk. That malformation is a blood-bubble in the brain and can congest the heart or crush the brain, he said.

“We treat it now with this fancy, sophisticated acrylic. All of you know this thing. We call it Krazy Glue,” Berenstein said in his TEDMED lecture.

The surgical version of the glue cements “the short circuit” between the artery and a corresponding vein, Berenstein said. “We have reconstructed the normal anatomy and got rid of this big bubble. These kids used to die. … We’ve gotten over 250 of these kids treated already and about 70 or 80 percent of them, we get them normal.”

When he wanted to use glue to treat his initial patient with that cerebral flaw, the hospital didn’t carry the necessary acrylic.

“The first one,” he said, “we actually got it from the hardware store.”

Meanwhile, baby Ashlyn will spend a few more days having the fluids from the aneurysm drain away while her medical team watches.